Surgery for Valve Problems

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10/28/2013

If you have been diagnosed with a valve problem, one of the four valves in your heart doesn't work properly and you may need treatment to feel better and reduce your risk of stroke, heart failure, and sudden cardiac arrest. The best treatment for you will depend on a number of factors: your age, type of valve disease, severity of the damage, symptoms, structure of your heart, other medical conditions, and your lifestyle. Surgery is the most common method for repairing or replacing a valve.

If you have open-heart surgery to repair or replace a valve, you will receive a general anesthetic and your heart surgeon will make an incision the length of your breast bone to expose your heart. You will be connected to a heart-lung machine, which will take over your breathing and blood circulation during the surgery. The surgeon will stop your heart, make an incision to expose the valve, and either repair it or replace it by cutting out the old valve and sewing in the new one. Once this is complete, your breast bone will be sutured back together.

What to Expect After Valve Surgery

Recovery time in the hospital after valve surgery is approximately one week. The first part of that time may be in the intensive care unit (ICU) so members of your healthcare team can closely monitor your heart, blood pressure and oxygen, and heart sounds.

It takes time to heal from open-heart surgery. You will receive therapy to prevent complications such as pneumonia, collapsed lung, or infection. A nurse or therapist may lead you in deep breathing exercises and coughing and encourage you to move your legs to reduce the chance of blood clots forming. Your therapy may also include gentle patting on the back to loosen secretions in the lungs.

Physical therapy will also be part of the recovery process. In the hospital, you will be encouraged to walk around and shown how to move your arms without hurting your breastbone. You will also learn how to do daily activities in ways that will not interfere with the healing process. Full recovery can take two months.

Risks of Heart Valve Surgery

Like any surgery or medical procedure, heart valve surgery has risks. Talk with your doctor to understand your risks, which will vary from one person to the next depending on your personal circumstances and characteristics.

Mortality—The overall risk of death is about 1 to 2 out of 100 patients; however, it is important to keep in mind that your risk of death may be greater if you do nothing to treat the heart valve problem.

Irregular heart beat (arrhythmia)—Arrhythmia may need to be treated with blood-thinning medications to reduce the risk of blood clots.

Infection—If bacteria enter the bloodstream they can infect damaged heart tissue putting you at greater risk for endocarditis (inflammation of the heart’s inner lining - see Protecting Yourself from Endocarditis).

General risks associated with general anesthesia

General risks associated with surgery, for example, bleeding

Repeat surgery—Valve repair may not last or work as planned or a tissue valve may need to be replaced if it wears out.

It’s not unusual for people to say they feel worse immediately after surgery, but if you follow your doctor’s instructions and take good care of yourself after surgery it can make a big difference in how you feel and how quickly you recover.

Minimally Invasive Surgery

A relatively new development in valve repair and replacement is minimally invasive valve surgery (MIVS). Rather than opening the chest, it is now sometimes possible to perform this surgery from a much smaller incision in the side of the chest.

SecondsCount is a project of The Society for Cardiovascular Angiography and Interventions (SCAI)

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